title: Calcium and osteoprotegerin levels predict the progression of the abdominal aortic calcifications after kidney transplantation.
abstract: BACKGROUND
  Vascular calcifications (VCs) are a cardiovascular risk factor in patients affected by chronic kidney disease and after kidney transplantation (KTx). We evaluated the prevalence of VCs at the abdominal aortic site in KTx patients at the time of transplantation and 1 year after KTx, exploring the possibly associated factors.
  
  
  METHODS
  In 107 transplanted patients, the following parameters were evaluated at the first and twelfth month after KTx: the aortic calcification index (ACI), fibroblast growth factor 23, osteoprotegerin (OPG), fetuin A, and clinical and biochemical parameters. Patients were followed up for 2 years after KTx.
  
  
  RESULTS
  At the time of KTx, 60% of patients had some degree of VC (ACI>0), whereas 40% had no VC. One year after KTx, VCs worsened in 26% of patients, whereas in 74%, VCs remained stable or improved. The progression of VC was observed almost exclusively in patients with a positive ACI score at the first month. At the multivariate analysis, serum calcium, OPG, and estimated glomerular filtration rate were the only variables independently associated with the progression of VC.
  
  
  CONCLUSIONS
  VCs at the aortic site are frequent in KTx patients, and in a significant percentage of them, they tend to progress even in the short time. High levels of serum calcium and OPG are significantly associated with the progression of VCs. Whether these associations are based on a cause-effect relationship and their correction might impact on the calcification process could be ascertained by prospective interventional studies.
authors.affiliation: Department of Medicine and Medical Specialties, Unit of Nephrology, Dialysis, and Renal Transplant, Fondazione Istituto di Ricerca e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Meneghini
authors.forename: Anna
authors.initials: A
authors.lastname: Regalia
authors.forename: Carlo
authors.initials: C
authors.lastname: Alfieri
authors.forename: Francesco
authors.initials: F
authors.lastname: Barretta
authors.forename: Daniela
authors.initials: D
authors.lastname: Croci
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Gandolfo
authors.forename: Simone
authors.initials: S
authors.lastname: Vettoretti
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Rastaldi
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000378:metabolism / Q000473:pathology; D001018:Aortic Diseases / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D011183:Postoperative Complications / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D061205:Vascular Calcification / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D002118:Calcium